目的 研究豬肺磷脂聯(lián)合高頻振蕩通氣（HFOV）治療新生兒呼吸衰竭的臨床療效。方法 選取2018年4月-2019年12月河南科技大學(xué)第一附屬醫(yī)院收治的呼吸衰竭新生兒80例，隨機(jī)分為對(duì)照組和治療組，每組各40例。對(duì)照組給予HFOV治療，治療組在對(duì)照組的基礎(chǔ)上氣管內(nèi)插管滴注豬肺磷脂注射液，200 mg/kg。兩組患兒均連續(xù)治療3 d，或患兒臨床癥狀好轉(zhuǎn)、血?dú)夥治鼋Y(jié)果正常結(jié)束治療。觀察兩組患者臨床療效，同時(shí)比較治療前后兩組患兒血?dú)庵笜?biāo)、血清熱休克蛋白70（HSP70）水平、硫化氫（H₂S）水平和不良反應(yīng)。結(jié)果 治療后，對(duì)照組臨床總有效率為80.00%，顯著低于治療組的95.00%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患兒動(dòng)脈氧分壓（pO₂）、血氧飽和度（SaO₂）、動(dòng)脈二氧化碳分壓（pO₂）/氧體積分?jǐn)?shù)（FiO₂）顯著升高（P<0.05），pCO₂、氧合指數(shù)（OI）、呼吸指數(shù)（RI）顯著下降（P<0.05）；且治療組治療后血?dú)庵笜?biāo)明顯好于對(duì)照組（P<0.05）。治療后，兩組患兒HSP70和H₂S水平顯著降低（P<0.05），且治療組比對(duì)照組更低（P<0.05）。對(duì)照組不良反應(yīng)總發(fā)生率為47.50%，治療組總發(fā)生率為25.00%，兩組比較差異具有統(tǒng)計(jì)學(xué)差異（P<0.05）。結(jié)論 豬肺磷脂聯(lián)合HFOV可進(jìn)一步提高新生兒呼吸衰竭的臨床療效，改善患兒的肺氧合功能，降低血清HSP70和H₂S，扭轉(zhuǎn)機(jī)體的缺氧狀態(tài)。

Objective To investigate the effect of Poractant Alfa Injection combined with high frequency oscillatory ventilation in treatment of neonatal respiratory failure. Methods Children (80 cases) with respiratory failure in the First Affiliated Hospital of Henan University of Science and Technology from April 2018 to December 2019 were randomly divided into control and treatment groups, and each group had 40 cases. Children in the control group were administered with high frequency oscillatory ventilation. Children in the treatment group were endotracheal intubation infusion administered with Poractant Alfa Injection on the basis of the control group, 200 mg/kg. Children in two groups were treated for 3 d, or until the clinical symptoms improved and blood gas analysis results were normal. After treatment, the clinical efficacy was evaluated, and the blood gas indexes, the serum levels of HSP70 and H₂S, the adverse reactions in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 80.00%, which was significantly lower than 95.00% in the treatment group, and there were differences between two groups (P<0.05). After treatment, the pO₂, SaO₂, and pO₂/FiO₂ in two groups were significantly increased (P<0.05), but the pCO₂, OI, and RI in two groups were significantly decreased (P<0.05), and the blood gas indexes in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the HSP70 and H₂S levels in two groups were significantly decreased (P<0.05), and which in the treatment group were significantly lower than those in the control group (P<0.05). During the treatment, the adverse reactions rate in the control group was 47.50%, which was significantly higher than 25.00% in treatment the group, with significant difference between two groups (P<0.05). Conclusion Poractant Alfa Injection combined with high frequency oscillatory ventilation can furthuer improve the clinical efficacy of HFOV in treatment of neonatal respiratory failure, improve the lung oxygenation function, reduce the serum levels of HSP70 and H₂S, and reverse the anoxic state.

R985

河南省醫(yī)學(xué)科技攻關(guān)計(jì)劃項(xiàng)目（2018020162）